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Four states mull over bills for no-cost supplemental breast cancer screenings

por John R. Fischer, Senior Reporter | January 12, 2024
MRI Ultrasound Women's Health
Four states have introduced bills for no-cost supplemental breast cancer screenings.
Politicians in Florida, Vermont, Virginia, and New Hampshire are joining calls for supplemental breast imaging to be covered at no cost under insurance plans, introducing bills in their respective state legislatures.

In each individual bill, the representatives and senators sponsoring them say breast MR, ultrasound, and diagnostic mammography screenings should be covered by private insurance with no fees for patients to create equitable access and bolster earlier detection of cancer. If successful, the states will be among 20 others that have enacted laws to boost insurance coverage for such exams.

Under the Affordable Care Act, no-cost mammograms are available for initial screenings, but about 12% of patients are referred for additional imaging due to abnormal findings. Many, however, choose not to undergo these exams due to high costs.
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"We are seeing an increased interest due to the momentum in other states. We’ve found that when speaking with legislators about this issue, there is a desire to remedy this situation and ensure all people have access to the breast imaging they require," Molly Guthrie, vice president of policy and advocacy at breast cancer advocacy organization Susan G. Komen, told HCB News. "We know that the cost of these examinations is one of the factors impacting utilization."

Along with preventive screenings for colon, cervical, and prostate cancer, those for breast cancer have saved the U.S. economy at least $6.5 trillion over the last 25 years, according to a recent study out of the Universities of Chicago and Michigan. In a study of its own, Susan G. Komen found that out-of-pocket costs can range from $234 for a diagnostic mammogram to more than $1,000 for a breast MR exam, thereby potentially deterring preventive screenings and in the long-term, costing the U.S. more on advanced stage cancers, which are harder to cure, treat, or manage.

Several other states passed legislation in 2023 that requires insurance providers to cover supplemental screenings, including Missouri, Tennessee, Washington, Maryland, and New Mexico.

The federal government is also weighing in on the debate, with the House of Representatives introducing the Find It Early Act, which would eliminate out-of-pocket costs from private payors nationwide for these exams. That bill has garnered support from several patient and provider advocacy groups, including the American College of Radiology as well as high-profile figures like breast cancer survivor and journalist Katie Couric, who introduced it previously in December 2022. While the bill failed the first time around, it was reintroduced on May 8, and has been backed by over 450 radiologists.

A Senate companion bill has also been introduced.

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